Multifactorial intervention in individuals with type 2 diabetes and microalbuminuria: The Microalbuminuria Education and Medication Optimisation (MEMO) study

W. Crasto; J. Jarvis; K. Khunti; T. C. Skinner; L. J. Gray; J. Brela; J. Troughton; H. Daly; I. G. Lawrence; P. G. McNally; M. E. Carey; M. J. Davies

doi:10.1016/j.diabres.2011.05.008

Multifactorial intervention in individuals with type 2 diabetes and microalbuminuria: The Microalbuminuria Education and Medication Optimisation (MEMO) study

W. Crasto^*, J. Jarvis, K. Khunti, T. C. Skinner, L. J. Gray, J. Brela, J. Troughton, H. Daly, I. G. Lawrence, P. G. McNally, M. E. Carey, M. J. Davies

^*Corresponding author for this work

Inflammation, Metabolism and Oxidation

34 Citations (Scopus)

Abstract

Aims: To determine whether tighter cardiovascular risk factor control with structured education in individuals with type 2 diabetes (T2DM) and microalbuminuria benefits cardiovascular risk factors. Methods: Participants from a multiethnic population, recruited from primary care and specialist clinics were randomised to intensive intervention with structured patient (DESMOND model) education (n= 94) or usual care by own health professional (n= 95). Primary outcome: change in HbA1c at 18. months. Secondary outcomes: changes in blood pressure (BP), cholesterol, albuminuria, proportion reaching risk factor targets, modelled cardiovascular risk scores. Results: Mean (SD) age and diabetes duration of participants were 61.5 (10.5) and 11.5 (9.3) years, respectively. At 18. months, intensive intervention showed significant improvements in HbA1c (7.1(1.0) vs. 7.8(1.4)%, p< 0.0001), systolic BP (129(16) vs. 139(17) mmHg, p< 0.0001), diastolic BP (70(11) vs. 76(12) mmHg, p< 0.001), total cholesterol (3.7(0.8) vs. 4.1(0.9) mmol/l, p= 0.001). Moderate and severe hypoglycaemia was 11.2 vs. 29.0%; p= 0.001 and 0 vs. 6.3%; p= 0.07, respectively. More intensive participants achieved ≥3 risk factor targets with greater reductions in cardiovascular risk scores. Conclusions: Intensive intervention showed greater improvements in metabolic control and cardiovascular risk profile with lower rates of moderate and severe hypoglycaemia. Intensive glycaemic interventions should be underpinned by structured education promoting self-management in T2DM.

Original language	English
Journal	Diabetes Research and Clinical Practice
Volume	93
Issue number	3
Pages (from-to)	328-336
Number of pages	9
ISSN	0168-8227
DOIs	https://doi.org/10.1016/j.diabres.2011.05.008
Publication status	Published - 1 Sept 2011

Keywords

Microalbuminuria
Structured education
Type 2 diabetes

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.diabres.2011.05.008

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Crasto, W., Jarvis, J., Khunti, K., Skinner, T. C., Gray, L. J., Brela, J., Troughton, J., Daly, H., Lawrence, I. G., McNally, P. G., Carey, M. E., & Davies, M. J. (2011). Multifactorial intervention in individuals with type 2 diabetes and microalbuminuria: The Microalbuminuria Education and Medication Optimisation (MEMO) study. Diabetes Research and Clinical Practice, 93(3), 328-336. https://doi.org/10.1016/j.diabres.2011.05.008

Multifactorial intervention in individuals with type 2 diabetes and microalbuminuria : The Microalbuminuria Education and Medication Optimisation (MEMO) study. / Crasto, W.; Jarvis, J.; Khunti, K. et al.

In: Diabetes Research and Clinical Practice, Vol. 93, No. 3, 01.09.2011, p. 328-336.

Research output: Contribution to journal › Journal article › Research › peer-review

Crasto, W, Jarvis, J, Khunti, K, Skinner, TC, Gray, LJ, Brela, J, Troughton, J, Daly, H, Lawrence, IG, McNally, PG, Carey, ME & Davies, MJ 2011, 'Multifactorial intervention in individuals with type 2 diabetes and microalbuminuria: The Microalbuminuria Education and Medication Optimisation (MEMO) study', Diabetes Research and Clinical Practice, vol. 93, no. 3, pp. 328-336. https://doi.org/10.1016/j.diabres.2011.05.008

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abstract = "Aims: To determine whether tighter cardiovascular risk factor control with structured education in individuals with type 2 diabetes (T2DM) and microalbuminuria benefits cardiovascular risk factors. Methods: Participants from a multiethnic population, recruited from primary care and specialist clinics were randomised to intensive intervention with structured patient (DESMOND model) education (n= 94) or usual care by own health professional (n= 95). Primary outcome: change in HbA1c at 18. months. Secondary outcomes: changes in blood pressure (BP), cholesterol, albuminuria, proportion reaching risk factor targets, modelled cardiovascular risk scores. Results: Mean (SD) age and diabetes duration of participants were 61.5 (10.5) and 11.5 (9.3) years, respectively. At 18. months, intensive intervention showed significant improvements in HbA1c (7.1(1.0) vs. 7.8(1.4)%, p< 0.0001), systolic BP (129(16) vs. 139(17) mmHg, p< 0.0001), diastolic BP (70(11) vs. 76(12) mmHg, p< 0.001), total cholesterol (3.7(0.8) vs. 4.1(0.9) mmol/l, p= 0.001). Moderate and severe hypoglycaemia was 11.2 vs. 29.0%; p= 0.001 and 0 vs. 6.3%; p= 0.07, respectively. More intensive participants achieved ≥3 risk factor targets with greater reductions in cardiovascular risk scores. Conclusions: Intensive intervention showed greater improvements in metabolic control and cardiovascular risk profile with lower rates of moderate and severe hypoglycaemia. Intensive glycaemic interventions should be underpinned by structured education promoting self-management in T2DM.",

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AU - Jarvis, J.

AU - Khunti, K.

AU - Skinner, T. C.

AU - Gray, L. J.

AU - Brela, J.

AU - Troughton, J.

AU - Daly, H.

AU - Lawrence, I. G.

AU - McNally, P. G.

AU - Carey, M. E.

AU - Davies, M. J.

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AB - Aims: To determine whether tighter cardiovascular risk factor control with structured education in individuals with type 2 diabetes (T2DM) and microalbuminuria benefits cardiovascular risk factors. Methods: Participants from a multiethnic population, recruited from primary care and specialist clinics were randomised to intensive intervention with structured patient (DESMOND model) education (n= 94) or usual care by own health professional (n= 95). Primary outcome: change in HbA1c at 18. months. Secondary outcomes: changes in blood pressure (BP), cholesterol, albuminuria, proportion reaching risk factor targets, modelled cardiovascular risk scores. Results: Mean (SD) age and diabetes duration of participants were 61.5 (10.5) and 11.5 (9.3) years, respectively. At 18. months, intensive intervention showed significant improvements in HbA1c (7.1(1.0) vs. 7.8(1.4)%, p< 0.0001), systolic BP (129(16) vs. 139(17) mmHg, p< 0.0001), diastolic BP (70(11) vs. 76(12) mmHg, p< 0.001), total cholesterol (3.7(0.8) vs. 4.1(0.9) mmol/l, p= 0.001). Moderate and severe hypoglycaemia was 11.2 vs. 29.0%; p= 0.001 and 0 vs. 6.3%; p= 0.07, respectively. More intensive participants achieved ≥3 risk factor targets with greater reductions in cardiovascular risk scores. Conclusions: Intensive intervention showed greater improvements in metabolic control and cardiovascular risk profile with lower rates of moderate and severe hypoglycaemia. Intensive glycaemic interventions should be underpinned by structured education promoting self-management in T2DM.

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Multifactorial intervention in individuals with type 2 diabetes and microalbuminuria: The Microalbuminuria Education and Medication Optimisation (MEMO) study

Abstract

Keywords

UN SDGs

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